Background to this inspection
Updated
16 December 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by three inspectors. A fourth inspector made calls to people’s relatives after the site visit.
Service and service type
The Laurels Care Centre Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service has not had a manager registered with the Care Quality Commission (CQC) for over a year. A new manager was appointed in February 2020 but has yet to apply to be registered with us.
Notice of inspection
We gave a short period of notice of the inspection. This was because we were responding to risk concerns, and wanted to be assured that no one at the home was symptomatic in light of the COVID-19 pandemic
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke in-person with two people who lived at the care home, a visiting GP, and various managers and staff who worked there including, the services relatively new manager, a lead nurse, four care workers and an activities coordinator.
We looked at five people’s care records, two staff files, and multiple medicines, staff training and supervision records.
We used the Short Observational Framework for Inspection (SOFI) during our inspection. SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
After the inspection
We made contact with relatives of people living at the home. We also reviewed additional documentation as we requested from the home manager.
Updated
16 December 2020
About the service
The Laurels is a care home that was providing nursing and personal care to 17 older people at the time of our inspection. The service can support up to a maximum of 68 people.
The premises is divided into three separate units, each of which has their own adapted facilities (the 2nd floor unit remains closed indefinitely for refurbishment).
Approximately half the people using the service were living with dementia.
People’s experience of using this service and what we found
The provider still needed to make substantial improvements to ensure the service was suitably governed. Staff had not received up to date infection control training in light of the COVID-19 pandemic, nor did they always wear Personal Protective Equipment (PPE) correctly.
Management did not ensure that people received care in line with their assessed care needs, nor did staff always receive appropriate training to support them to care for people's specific needs. Best practice was not adhered to when seeking consent from people.
Quality assurance systems were not always completed to ensure care delivery was appropriately delivered and reviewed.
Monitoring of incidents and accidents still required improvement to ensure they were appropriately recorded and investigated. People’s risk assessments had improved to ensure they were clearer in defining people’s specific needs. Staff were safely recruited, and there were suitable safeguarding processes in place to support staff to express any concerns.
Staff, people and relatives felt that management support had improved. The service worked effectively with partnership agencies to ensure that people’s care needs were met.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (published 18 September 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.
Why we inspected
We undertook this focused inspection to check they had followed the action plan they sent us and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions; Is the service Safe, Effective and Well-led?, which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Laurels Care Centre Limited on our website at www.cqc.org.uk.
Enforcement:
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to good governance at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.